Exploring Risk and Resilience Factors in Families of Children with FASD: A Mixed Methods Approach - Project Summary/Abstract Prenatal alcohol exposure (PAE) can cause a wide range of neurocognitive, behavioral, and functional impairments that persist throughout the lifespan. The collective impairments of PAE are known as fetal alcohol spectrum disorders (FASD). FASD is an umbrella term which encompasses several diagnoses of different degrees of severity. Despite the well-known teratogenic effects, recent estimates indicate that as many as 1 in 10 women consume alcohol during pregnancy. Thus, prenatal exposure to alcohol is a significant public health concern. Furthermore, there is little research on the impact of the postnatal environment on developmental outcomes in children with FASD. Factors in the postnatal environment may act as risk factors which contribute to adverse outcomes or protective factors of resilience to promote positive outcomes in this population. Children who have been prenatally exposed to alcohol may face unique early life challenges in the family environment that may further impact cognitive and behavioral functioning. However, the family environment in children with PAE is not well-understood. Children with PAE often experience unique family environments due to seperation from their biological parents and are often raised in adoptive care or by other related family members. Thus, many children with FASD experience high rates of adverse early life experiences and an unstable home environment. It is unknown how these distinctive postnatal family factors impact developmental trajectories in individuals with prenatal alcohol exposure. As such, these factors are important to further explore to identify intervention targets and areas of support needed in families with children or adolescents with PAE. To address this disparity, the proposed project seeks to: 1) Identify risk and protective factors of resilience at the family level in children and adolescents with FASD; 2) Examine the impact of family risk and resilience factors on cognitive, behavioral, and functional outcomes in children and adolescents with FASD; 3) Explore perspectives on family risk and protective factors of resilience through the lived experiences of caregivers across multiple family environments. To capture the diversity of family experiences in children with PAE, three groups of caregivers will be explored: biological parents, adoptive or foster parents, and other related caregivers. A mixed-methods approach using both qualitative interviews and additional quantitative measures will be used in caregivers of children with prenatal alcohol exposure to provide novel information about the lived experiences of families and to capture their perspectives on current barriers. Successful completion of these Aims will provide direct clinical impact by critically informing family-focused interventions that promote protective factors of resilience and target risk factors in the family environment to address this population's unique needs and improve lifetime outcomes in individuals affected by prenatal alcohol exposure.
